National Provider Identifier

Jack C Wong, BSC

Jack C Wong, BSC is listed in the NPPES registry with a primary specialty of Pharmacist in Rochester, NY and a listed phone number of (585) 271-6736.

NPI 1558540203Rochester, NYPharmacist

Profile Overview

NPI
1558540203
Provider Type
Individual
Primary Specialty
Pharmacist
Enumeration Date
October 30, 2007
Last Updated
October 30, 2007

Practice Location

  • 626 Park Ave
  • Rochester, NY 14607-2943

Phone: (585) 271-6736

Mailing Address

  • 5 Peregrine Way
  • Webster, NY 14580-8784

Specialties

  • Pharmacist (183500000X)
Full Record
NPI
1558540203
Entity Type
Individual
Last Name
Wong
First Name
Jack
Middle Name
C
Name Prefix
Mr.
Credential
BSC
Mailing Street Address
5 Peregrine Way
Mailing City
Webster
Mailing State
NY
Mailing ZIP Code
14580-8784
Mailing Country
US
Mailing Phone
(585) 872-4805
Mailing Fax
(585) 271-0172
Practice Street Address
626 Park Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14607-2943
Practice Country
US
Practice Phone
(585) 271-6736
Practice Fax
(585) 271-0172
Enumeration Date
October 30, 2007
Last Updated
October 30, 2007
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pharmacist (183500000X)